Anti-D administration after spontaneous miscarriage for preventing Rhesus alloimmunisation
Cochrane Reviews,  Review Article

Karanth L. et al – To assess the effects of administering anti–D immunoglobulin (Ig) after spontaneous miscarriage in a Rh–negative woman, with no anti–D antibodies. It was concluded that there ais insufficient data available to evaluate the practice of anti–D administration in an unsensitised Rh–negative mother after spontaneous miscarriage. Thus, until high–quality evidence becomes available, the practice of anti–D Immunoglobulin prophylaxis after spontaneous miscarriage for preventing Rh alloimmunisation cannot be generalised and should be based on the standard practice guidelines of each country.

Methods

  • The authors searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 December 2012).
  • Randomised controlled trials (RCT) in Rh–negative women without antibodies who were given anti–D Ig following spontaneous miscarriage compared with no treatment or placebo treatment following spontaneous miscarriage as control were included.
  • Two review authors independently assessed trials for inclusion and trial quality. Two review authors extracted data and checked it for accuracy.
  • The study included one RCT, involving 48 women who had a miscarriage between eight to 24 weeks of gestation.
  • Of the 19 women in the treatment group, 14 had therapeutic dilatation & curettage (D&C) and five had spontaneous miscarriage; of the 29 women in the control group, 25 had therapeutic D&C and four had spontaneous miscarriage.
  • The treatment group received 300 µg anti–D Ig intramuscular injection and were compared with a control group who received 1 cc homogenous gamma globulin placebo.

Results

  • This review's primary outcomes (development of a positive Kleihauer Betke test (a test that detects fetal cells in the maternal blood; and development of RhD alloimmunisation in a subsequent pregnancy) were not reported in the included study.
  • Similarly, none of the review's secondary outcomes were reported in the included study: the need for increased surveillance for suspected fetal blood sampling and fetal transfusions in subsequent pregnancies, neonatal morbidity such as neonatal anaemia, jaundice, bilirubin encephalopathy, erythroblastosis, prematurity, hypoglycaemia (low blood sugar) in subsequent pregnancies, maternal adverse events of anti–D administration including anaphylactic reaction and blood–borne infections.
  • The included study did report subsequent Rh–positive pregnancies in three women in the treatment group and six women in the control group. However, due to the small sample size, the study failed to show any difference in maternal sensitisation or development of Rh alloimmunisation in the subsequent pregnancies.

Please login or register to follow this author.
Are you sure you want to Unfollow this Author?
► Click here to access PubMed, Publisher and related articles...
<< Previous Article | Next Article >>

Your Unread Messages in Obstetrics & Gynecology

See All >> Messages include industry-sponsored communications and special communications from MDLinx

Most Popular Obstetrics & Gynecology Articles

1 A revised birth weight reference for the United States Obstetrics and Gynecology, July 14, 2014    Clinical Article

2 Effect of oral magnesium supplementation on physical performance in healthy elderly women involved in a weekly exercise program: A randomized controlled trial American Journal of Clinical Nutrition, July 17, 2014    Clinical Article

3 Metformin in reproductive health, pregnancy and gynaecological cancer: Established and emerging indications Human Reproduction Update, July 24, 2014    Review Article

4 First trimester coffee and tea intake and risk of gestational diabetes mellitus: A study within a national birth cohort BJOG: An International Journal of Obstetrics and Gynaecology, July 7, 2014    Clinical Article

5 Seafood consumption and umbilical cord blood mercury concentrations in a multiethnic maternal and child health cohort Full Text BMC Pregnancy and Childbirth, July 3, 2014    Free full text    Clinical Article

6 A blinded, randomized controlled trial of high-dose vitamin D supplementation to reduce recurrence of bacterial vaginosis American Journal of Obstetrics and Gynecology, July 2, 2014    Clinical Article

7 Effects of a eucaloric reduced-carbohydrate diet on body composition and fat distribution in women with PCOS Metabolism, July 22, 2014    Clinical Article

8 High-dose vaginal metronidazole for recurrent bacterial vaginosis: A pilot study Journal of Lower Genital Tract Disease, April 3, 2014    Clinical Article

9 Partly replacing meat protein with soy protein alters insulin resistance and blood lipids in postmenopausal women with abdominal obesity The Journal of Nutrition, July 23, 2014    Clinical Article

10 Oral antihypertensive therapy for severe hypertension in pregnancy and postpartum: A systematic review BJOG: An International Journal of Obstetrics and Gynaecology, June 5, 2014    Evidence Based Medicine    Review Article

11 The effect of chromium supplementation on polycystic ovary syndrome in adolescents Journal of Pediatric and Adolescent Gynecology , May 30, 2014    Clinical Article

12 Rate of low vitamin D levels in a low-risk obstetric population Journal of Midwifery and Women's Health, July 1, 2014    Clinical Article

13 Soy food and isoflavone intake and endometrial cancer risk: The Japan Public Health Center-based prospective study BJOG: An International Journal of Obstetrics and Gynaecology, June 30, 2014    Clinical Article

14 Oophorectomy and hysterectomy and cancer incidence in the cancer prevention study-II nutrition cohort Obstetrics and Gynecology, June 4, 2014    Clinical Article

15 Physical activity in pregnancy and neonatal body composition: The healthy start study Obstetrics and Gynecology, July 30, 2014    Clinical Article

16 Effects of yoga on arm volume among women with breast cancer related lymphedema: A pilot study Journal of Bodywork & Movement Therapies , July 15, 2014    Clinical Article

17 Mode of delivery in women with class III obesity: Planned cesarean compared to induction of labor American Journal of Obstetrics and Gynecology, July 7, 2014    Clinical Article

18 Vitamin D and menopause-A narrative review Maturitas, June 25, 2014    Review Article

19 Prospective association between red and processed meat intakes and breast cancer risk: modulation by an antioxidant supplementation in the SU.VI.MAX randomized controlled trial International Journal of Epidemiology, July 8, 2014    Clinical Article

20 Association between labetalol use for hypertension in pregnancy and adverse infant outcomes European Journal of Obstetrics & Gynecology and Reproductive Biology, February 17, 2014    Clinical Article

Indexed Journals in Obstetrics & Gynecology: Obstetrics and Gynecology, American Journal of Obstetrics and Gynecologymore

Register now to view all the MDLinx contents (FREE)!

  • Stay current on the latest literature, research and clinical news
  • Get special communications and offers from MDLinx and our sponsors
  • Receive invitations to paid market research
View Samples and Register

Connect with us, stay current.

Receive the latest mecial news
updates for free via email

Sign up!

Subscribe to our free RSS feeds:

Get the latest news in your specialty automatically added to your newsreader or your personal My Yahoo!, Google, My MSN or My AOL page. Learn More

Close